| Background and ObjectiveMultiple system atrophy(MSA)is a rare,sporadic,fatal,adult-onset neurodegenerative disease with unknown etiology.The pathological marker is alpha-synuclein.The diagnosis is mainly based on clinical manifestations and imaging studies.The main treatment is symptomatic supportive treatment,and the curative effect is not good.Therefore,it is especially important to find more specific diagnostic basis.Recent studies have shown that homocysteine(Hcy)causes neuronal degeneration and necrosis through cytotoxicity,oxidative stress,and mitochondrial function,and is associated with neurodegenerative diseases.Blood lipids can affect myelination,oxidation,and stabilization of cell membranes,leading to the development of neurodegenerative diseases.Uric acid(UA)is an antioxidant that has neuroprotective effects.Studies have confirmed that MSA is associated with Hcy,blood lipids,and uric acid levels in the body,but the three have little research on the diagnostic value of MSA.In this study,we compared blood Hcy,folic acid,vitamin B12(Vitamin B12,Vita B12),total cholesterol(TCHO),triglyceride(TG),low-density lipoprotein cholesterol(Low)in each subgroup and control group of MSA.Density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),UA difference,to explore the correlation between Hcy,blood lipids,UA and MSA on the incidence and severity of the disease,and to evaluate Hcy,The diagnostic value of blood lipids and UA for MSA.Subjects and Methods1.Case selection: 188 patients with MSA who were admitted to the Department of Neurology,the Fifth Affiliated Hospital of Zhengzhou University and the First Affiliated Hospital from January 2016 to May 2018,including 83 MSA-P and 105 MSA-C were collected.Eighty-one patients with no neurological disease matching the age,sex,hypertension,and diabetes prevalence of the MSA group were selected as the control group.2.Research method:Two independent samples t-test and chi-square test were used to compare the differences between the MSA group and the general data of each subtype and the healthy control group.Spearman correlation method was used to analyze the correlation between various blood index levels and age,age,and UMSRS-I score.A new set of variables Y was calculated by binary logistic regression analysis,and the ROC curve was used to understand the observation items and new The diagnostic value of the variable Y for MSA.Results1.There was no significant difference in the prevalence of gender,age,hypertension and diabetes between MSA-P group,MSA-C group and control group(P>0.05).The Hcy level was higher in MSA group than in the control group.Significance(P<0.01),especially in women;the levels of folic acid,VitB12,TG,and UA in the MSA group were lower than those in the control group,and the difference was statistically significant(P = 0.000,0.008,0.019,0.031),especially in men.The level of folic acid in MSA-P group was lower than that in MSA-C group,and the difference was statistically significant(P<0.01).2.Correlation analysis showed that UMASRS-I was positively correlated with Hcy(r total = 0.337,r male = 0.387,r female = 0.284,P < 0.01);URMSRS-I score was negatively correlated with folate level(r total =-0.254),r female =-0.324,P <0.01);URMSRS-I score was negatively correlated with VitB12 level(r female =-0.336,P <0.01);URMSRS-I score was significantly positively correlated with disease duration(r total = 0.533,r male=0.470,r female=0.606,P<0.01);age was positively correlated with Hcy level(r total=0.178,r male=0253,P<0.05).3.The area under the ROC curve showed that the AUC of blood Hcy,folic acid and TG were 0.608,0.778,0.604(P<0.01),and the AUC of Y value was 0.695(P<0.001).Conclusions1.Hcy,folic acid,Vita B12,blood lipid,and UA levels were statistically different in patients with multisystem atrophy,and there were gender differences.2.Hcy,folic acid,and lipid levels may be related to the onset of multisystem atrophy.3.Hcy,folic acid,and lipid levels may be related to the severity of the condition. |
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